Adult Spondylolisthesis Preoperative Radiograph Stability On The Affection Of Surgical Reduction And Clinical Efficacy Observation

Objective To investigate the adult lumbar spondylolisthesis preoperative radiograph stability of pathological segment would affect the surgical reduction and clinical efficacy.Methods A retrospective analysis of adult lumbar spondylolisthesis under PLIF surgery with a total of 104 cases from November 2011 to June 2014.25 males,79 women, aged 21-83 years,72 cases isthmic spondylolisthesis,32 cases degenerative spondylolisthesis. Beteeen lumbar flexion and extension radiographs, sagittal slip range> 3mm is defined as translation unstable group (group A1) 27 cases, the angle of rotation range> 10° is defined as the angle unstable group (group A2) 25 cases, the remaining classified as stable group (group B) 52 cases as the control group. Measured lateral radiograph Translation distances(TD), segment angle(SA), slip rate(SR) before surgery and three days after surgery.Record complications; following-up JOA score and VAS score before surgery, after 1 month and last follow-up to assess clinical efficacy.Results All three groups were obtained imaging reduction. Not only between the group A1 and group B, but also between group A2 and group B have no significant difference on the reduction correction. Group Al and group B of patients who using pulling pedicle screw get better reduction correction (P <0.05), but group A2 of patients who using conventional pedicle screws and pulling pedicle screws have similar reduction correction. Unstable group patients(group A1 and group A2) have higher preoperative low back pain and leg pain VAS score than the stable group patients (group B), lower after 1 month, but there was no significant difference at the last follow-up. Preoperative JOA score of unstable group patients(group A1 and group A2) are lower than the stable group patients (group B),higher after 1 month, but there was no significant difference at the last follow-up. No significant difference in complications compare group A1 to group B, so as group A2 and group B.Conclusion The sbability of Adult lumbar spondylolisthesis in pathological segment radiograph before surgery does not affect the surgical reduction correction capability, pulling pedicle screws may have a more powerful spondylolisthesis correction capability than conventional pedicle screws. Patients who with preoperative segmental instability manifestated severer symptoms and poor neurological disfunction compare with the stable patients, but faster recovered 1 month after surgery, following-up 18-48 months, an average of 32 months, similar clinical efficacy was obtained. Stability of preoperative pathological segment does not affect the incidence of surgical complications.